RPL (05-2910)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T-iht 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 05-00002-9.10
Property Address: 81240 NATIONAL DR
APN: 767-500-020- - -
�� tion des n: POOL - RESIDENTIAL
W
roper trtg: LOW DENSITY RESIDENTIAL
JP^,P Ication valva 20000
2. 11005
Jv`Applicant: Architect or Engineer:
C� F1op,f`:� ,dpi
-----------------
LICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with '
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
License Class: License No.:
DazeC
Contractor: l!i
✓ NER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
. following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars 155001.:
(_ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
and who does the work himself or herself through his or her own employees, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
one year of completion, the owner -builder will have the burden of proving that he or she did not build or
improve for the purpose of sale.).
1 _ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
( ) I am exempt under Sec. , B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirmunderpenalty of perjury that there is a construction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERM[T
VOICE (760) 777-7012•
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/13/05'
Owner:
BARTOLO
750 JABOR DRIVE
SCOTTSVALLEY, CA 95066
Contractor:
PICASSO POOLS, INC
WCC: STATE FUND
WC: 1709395 12/01/05
CSLB: 810111 07/31/06
-----------------------------------------------
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations: '
_ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier B C27 C53 Policy Number - - - - - - - - - - - - - - -
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner so as to become subject to the workers' compensation laws of California,
and agree that, if I should become subject to the workers' compensation provisions of Section
3700 of the Labor Code, I shall forthwith comply with those provisions.
atm e: /7� Applicanv,/,u
00,
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS (5100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose request and for
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of La Quinta, its officers, agents and employees for any act or omission related to the work being
performed under or following issuance of this permit. '
2. Any permit issued as a result of this application becomes null and void if work is not commenced
within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject
permit to cancellation. '
1 certify that I have read this application and state that the above information is correct. I agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of this c ty to enter upon the above-mentioned prope for i ection purposes.
Dat Signature (Applicant or AgenJ�
Application Number
.. 05-00002910
:,,Permit . .
BLDG POOL PERMIT
Additional desc .
Permit Fee.
207.00 Plan Check
Fee
134.55
Issue Date . . . .
Valuation
20000
Expiration Date
1/09/06
Qty Unit Charge
Per
Extension
BASE FEE
45.00
18.00 9.0000
THOU BLDG 2,001-25,000
162.00 .
Permit . . .
MECH POOL
Additional desc .
Permit Fee
26.00 Plan Check
Fee
6.50 '
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date
.1/09/06
Qty Unit Charge
Per
Extension
_
BASE FEE
15.00
1.00 11.0000
EA MECH FURNACE >100K
11.00
Permit . . .
ELEC POOL PERMIT -RES
". Additional desc .
Permit Fee
-. 45.00 Plan Check
Fee
Issue Date . . . .
Valuation
0
Expiration Date
1/09/06
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 30.0000
----------------------------------------------------------------------------
EA ELEC PRIVATE SWIMMING POOL
X30.00
Permit .' . . .
PLUMBING
Additional desc
Permit Fee
33.00 Plan Check
Fee
8.25
Issue Date
Valuation
. . .
0
Expiration Date
.1/09/0.6
Qty Unit Charge
Per
Extension
BASE FEE
15.00 t
2.00 6.0000
EA PLB FIXTURE
12.00
1.00 3.0000
EA PLB WATER INST/ALT/REP
3.0,0
1.00 3.0000
EA PLB GAS PIPE 1-4 OUTLETS
3.00
----------------------------------------
Special Notes and Comments
POOL & SPA ONLY. ALARMS/BARRIERS SHALL
LQPERD4IT
Application Number . . . 05-00002910
--- - - - - - ------------------
Special Notes and Comments
----- --------
----- - - - - -- ---
BE IN PLACE PRIOR TO PRE -PLASTER,
INSPECTION. EQUIPMENT ENCLOSURE NOT
INCLUDED IN.PERMIT.
-Fee summary Charged Paid
Credited
Due.
". Permit Fee Total 311.00 .00
.00
311.00
- Plan Check Total 160.55 .00
.00
160.55
Grand Total- 471.55 .00
...00
471.55 ,
LQPERMIT - -
.
t
Total Permit Fees
Bi" #City
of La Quina
Building 8t Safery Division
P.O. Box 1504, 78-495.Calte Tampico.
Permit ;rl
La .Quinta, CA 92253 - (760) 777-7012
05' 2 9 ro
Building Permit Application and Tracking Sheet
.JC
Project Address: Ll
a ' • ,lon..«•ner's
7JAddress:
Name: Doin T dr, )�L,77�
A. P. Number:
S
Legal.. Description:,
i ST. Zip:C1
Contractor. �( C l
H (1 L 6,
elephone.:
L
40
Address: '. aD D i�.� i
�,1 K ; f 6
Project Description: .p
4
City. ST. Zip:. I lri J �. ; J
wit 3
•4
rr''
Telephone: e 3 — `-G
P � V
�C
'State Lie. : U
City Lic.'r: 0.3 X8-3
Arch_ Eng:-- Designer
Address:
City. ST. Zip:
Telephone:
Occupancy:
Construction Type: :
State Lic.,�.
Project type (circle one): New Add'n Alter Repair Demo
Name?of Contact Person:
Sq. FL:
Stories: Units:
Telephone # of Contact Person:
Estimated Value of Proiect: �®
APPLICANT: DO NOT WRITE BELOW THIS LINE
a;
Submittal I
Req'd I
Rec'd
TRACKING
PERNM FEES
Plan Sets I
Plan Check submitted
�US
Item
Amount
Structural Calcs.
Reviewed. ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Cahn.
Plans picked up
Ctinstruction
'Flood: plain plan
I
Plans resubmitted
Mechanical
Grading plan
2, Review. ready for correctionsrtssue
� r f
�Electricall _
Subeontactor List
Called Contact Person
Plumbing
'Grant Deed
Plans picked up
S.M.I.
H'.0 -A. Approval
'Plans resubmitted
Grading .
IN HOUSE:-
'"' Review. ready for corrections/issue__,
eveln en r- lmnacl Per_
'Planning Approval
Called Contact Person
A.I.P.P.
,Pub. Wks. Appr
Date or permit issue
"School Fees
Total Permit Fees
09/16/2005 15:26 FAX PARABONPSCHIMID
M
INSULATION ERTIFICATE
This is to certify that insulation has been installed ir. confo mance with the current energy
regulation, California Administrative Code, Title 24, Stato of California, in the building at
NORMAN ESTATES, LOT 45, PHASE 3, LA QUINTA CA
CEILINGS:
TYPE: BATTS MANUFACTURER: Cetaintaed THICKNESS: R-33
WALLS:
TYPE: BATTS MAUNFACTURER: Ceitaink.ed THICKNESS. R-'9
GENERAL CONTRACTOR: EHLINE CO BUILDERS LICENSE #
3Y:
PARA N SCHMID 8�."NG PRODUCTS A N.ASCO Company LICENSE # 221517
gy_ �G<.�i'��n.! TITLc: ACCOUNT REPRESENTIVE DATE:_`
16005/014
SEP 27,2005 13:13 BCI*TESTING,ril
-let
000-000-06000
CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Page I of 7) CF -411
GREG NORMAN ESTATES 1`11-3,
'.='.9-13-05
Date
81240 National Drive La.!.Quinta CA" 92253
FHUNE CO.
Projet ,Address
cott
Builder Name
-_Plan. 1 ... (pg. I
Build 1,11,
VjITIM Henson ((.(.N (Y.'2004076) 11 250-7022Group
I'lin Number
2
HERS Kato Teleribunu
Sample (;ripup Number
45 (ph 3)
Certifying Signature Date
Sample I louse Number
Firm: RU Testing i.FAS FAS rmvidur: CALCERTS
Street Addre-m: PO Box 50575 Phoenix, AZ 85076
Copies to: Builder, HERS Nividvr
HERS RATER COMPXLIA CE STATEMENT
The house was: [3 irmicd Approved as part of sample testitig, but was not tested
As the Hh*KS niter providing diagriostic, w4 *ng xn(t reld xeri(4tion; l certify that the houses identified on this form comply
with the diagnostic tested compliance requirements its checked on this form,
0 The installer has provided a copy of CF -6R (Installation Ccrtirluaw, .
n Dlstribution system is fully ducted (i.e., does not use building vavitius a-8 plunini is or platkinn rcwm4 in lion of amts)
[3 Where cloth l)sckctl.rubboradliu.sivuduct Wp'uisinstalled, oiasiic anddrawbands; are used in combination with cloth
backed, rubber adhesive: thid tape be %eml lunks at dud tionquctious.
13 MINIMUM RF.QtIIRFMFNT-S FOR DICT LEAKAGE REDUCTION (;O,MPI,IA.N(;P CREDIT
Duct Diagnostic Leak ige Results (Maximum 6% Duet Leakage),
Measured
Duut Pressurisation Test Results ((,FM Q) 25 Ila) Values
Test I xaka�u Flow in CPM
if fan flow is calcuLAcd as 40N:Firkm'*,pirnaher qi*ti)nXqii(er cahaiiattxl-
vithie here,
I,-
ff ran flow is measured enter MCASUr", V81i1c her(.,
Leakage Llcrccntagc (100'x'Tcst UuktlijtJT- a.'n Flow)
Check Rnx sift P*ss o'r*F.4iI P;ivs=-6% tw less) e 11 D
Pass Fail
0THERMOSTATIC EXPANSION VALVE (TXV)-,
Ye, 0 No TheTmomatic. Fxp"nsion Wive is inWillcil is':
provided for inspection El El
Cs is a pass Pass Fail
❑ MINIMtIMRF.QtJIRFMFN'r-,FOR Dtl(-TDFSI(-NCOMPI,IANCF('REDIT
13 Yes 13 No AC( ' 'A Matival D Design requirements have been met (rater has
vcrificd that actual ' installation matches values in cl-IK and.
design on plan.
2. [3y cs [3NC, TXV i.,f in4billed or Fun flow has been vetiFied. Ifni) TXV,
verified fan flow matches design from cr, -I it.
Measured r -all Flow
13 0
Yes for both I and 2 is -a [lass P29S
Fail
Compliance Forms August ,2001, A-16
Page 12